178Lu Bronchiectasis and Small Airway Impaction

This is a case of a 68 year patient with both severe bronchiectasis in the upper lobes and mid lung regions and evidence of centrilobular emphysema and the the question raised is if the emphysema and bronchitis led to the bronchiectasis?

There are also feautures of prior TB with calcifications in the right upper lobe

different radiological COPD phenotypes based on the
- presence and severity of emphysema,
- bronchial wall thickening, and
- bronchiectasis.
Bronchiectasis caused by
- chronic airway inflammation and/or infection.
- prevalence in h COPD is high,
- especially advanced stages. T
- it is
  - a different clinical COPD phenotype
  - more frequent chronic bronchial infection
  - more severe
  - and more exacerbations,
  - poor prognosis. A

Diffuse Disease with Bronchiectasis noted in the Upper Lobes

CXR shows diffuse lung disease but findings of bronchiectasis in the upper lobes best identified in the right upper lobe
Ashley Davidoff MD TheCommonVein.net 68-bronchiectasis 001a

CXR shows diffuse lung disease but findings of bronchiectasis suggested in the upper lobes
Ashley Davidoff MD TheCommonVein.net 68-bronchiectasis 001b

Atelectasis and Calcification in the RUL raising the possibility that the bronchiectasis may be secondary to TB
Ashley Davidoff MD TheCommonVein.net bronchiectasis 008

Diffuse Disease, Upper Lobe and Mid Lung Predominance, Centrilobular Nodules Mosaic Attenuation and Suggestion of Centrilobular Emphysema